That's the question I know is running through your head before you ever say it out loud. If you're a first responder and you've ever sat across from a therapist and had to stop mid-sentence to explain what a "10-33" means, or why you laughed at something during a debrief that would make a civilian's jaw drop, or why "I'm fine" doesn't mean fine — you already know why this question matters. I've spent my career on your side of that line. I worked dispatch. I've stood on scene during crisis incidents and provided debriefings in the minutes and hours after the worst calls. I've done Title 25 evaluations in the ER at 3 a.m. I've sat in the room while a deputy tried to figure out how to tell his sergeant he needed help without it costing him his job. I'm not learning your world from a textbook — I was already in it. That matters more than people outside this field realize. When you don't have to translate, the actual work can start. You don't have to spend the first six sessions building a glossary for your therapist. You don't have to brace for the flinch when you describe what you saw, or soften it because you're worried they can't handle it. You don't have to explain that gallows humor isn't a red flag — it's how you've stayed functional. I also know the difference between what's normal operational stress and what's becoming something bigger. That distinction is everything. Not every bad call needs a diagnosis. Not every rough patch means you're broken. But some of it does need real intervention — and part of my job is knowing which is which, so we're not wasting your time treating something that doesn't need treating, or ignoring something that does. Here's what I want to be clear about: I'm not trying to take away what this job asks of you, and I'm not trying to talk you out of the career. I'm not here to convince you the job is the problem. My goal is to help you carry what you carry differently — so you can keep doing this work, and still come home able to be present with your family, still be yourself, still be sharp when it counts. If you've been putting off getting support because you didn't think anyone outside the job could understand it — I'd like the chance to prove that wrong. Michele Ogburn, MSW, LCSW, LIMHP, is the therapist behind Prairie Sky Counseling, specializing in first responders and high-responsibility helping professionals. She offers telehealth in Wyoming and Nebraska.
Learn what high-functioning anxiety is, recognize common signs, and understand how it can affect daily life, relationships, and overall well-being.
